Ultralow temperature cryoablation eliminated local electrograms in 92.5% of atrial and 96.9% of ventricular applications, creating transmural and durable lesions over 3 months in animal models.
Does ultralow temperature cryoablation create safe, effective, and durable atrial and ventricular lesions in preclinical large animal models?
Ultralow temperature cryoablation is a feasible and effective modality for creating durable, transmural atrial and ventricular lesions in preclinical models.
BACKGROUND: Ultralow temperature cyroablation (ULTC) is designed to create focal, linear, and circumferential lesions. The aim of this study was to assess the safety, efficacy, and durability of atrial and ventricular ULTC lesions in preclinical large animal models. METHODS AND RESULTS: The ULTC system uses nitrogen near its liquid-vapor critical point to cool 11-cm ablation catheters. The catheter can be shaped to specific anatomies using pre-shaped stylets. ULTC was used in 11 swine and four sheep to create atrial (pulmonary vein isolation and linear ablation) and ventricular lesions. Acute and 90-day success were evaluated by intracardiac mapping and histologic examination. Cryoadherence was observed during all ULTC applications, ensuring catheter stability at target locations. Local electrograms were completely eliminated immediately after the first single-shot ULTC application in 49 of 53 (92.5%) atrial and in 31 of 32 (96.9%) ventricular applications. Lesion depth as measured on histology preparations was 1.96 ± 0.8 mm in atrial and 5.61 ± 2.2 mm in ventricular lesions. In all animals, voltage maps and histology demonstrated transmural and durable lesions without gaps, surrounded by intact collagen fibers without injury to surrounding tissues. Transient coronary spasm could be provoked with endocardial ULTC in the left ventricle in close proximity to a coronary artery. CONCLUSIONS: ULTC created effective and efficient atrial and ventricular lesions in vivo without procedural complications in two large animal models. ULTC lesions were transmural, contiguous, and durable over 3 months.
Bourier et al. (Thu,) conducted a other in Preclinical atrial and ventricular ablation (n=15). Ultralow temperature cryoablation (ULTC) was evaluated on Acute and 90-day success evaluated by intracardiac mapping and histologic examination. Ultralow temperature cryoablation eliminated local electrograms in 92.5% of atrial and 96.9% of ventricular applications, creating transmural and durable lesions over 3 months in animal models.
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